A Comparison of 4 Analgesic Regimens for Acute Postoperative Pain Control in Breast Augmentation Patients

Tan, Pamela; Martin, Morgan S.; Shank, Nina; Myers, Leann; Wolfe, Emily T; Lindsey, John T.; Metzinger, Stephen E.

doi:10.1097/sap.0000000000001132

Cited by 21 publications

(6 citation statements)

References 50 publications

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“…Other clinical factors may affect analgesic efficacy as well, such as anatomical site, tissue vascularity, the variability of surgical procedures, and the coadministration of systemic analgesics. In fact, several studies of local infiltration in breast surgery, 31 urological laparoscopic surgery, 32 and total knee replacement, 33 reported that liposomal bupivacaine was not superior to conventional bupivacaine in analgesic efficacy.…”

Section: Anesthesia and Analgesiamentioning

confidence: 99%

Comparison of Liposomal Bupivacaine and Conventional Local Anesthetic Agents in Regional Anesthesia: A Systematic Review

Jin

Ding

Islam

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Pain is one of the most common adverse events after surgery. Regional anesthesia techniques are effective for pain control but have limited duration of action. Liposomal bupivacaine is a long-acting formulation of bupivacaine. We conduct this systematic review to assess whether liposomal bupivacaine may prolong the analgesic duration of regional anesthesia compared to conventional local anesthetic agents. METHODS: We systematically searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, Web of Science citation index, US clinical trials register, and recent conference abstracts for relevant studies. RESULTS: We identified 13 randomized controlled trials that compared the use of liposomal bupivacaine to conventional local anesthetics in regional anesthesia. There were 5 studies on transversus abdominis plane (TAP) block, 3 of which reported longer duration of analgesia with liposomal bupivacaine. One study reported comparable analgesia with liposomal bupivacaine TAP block compared to TAP block catheter. There were 3 studies on brachial plexus block, 2 of which reported that liposomal bupivacaine may provide longer analgesia. Studies on other techniques did not report significantly longer analgesia with liposomal bupivacaine. CONCLUSIONS: Currently, there is limited evidence suggesting that liposomal bupivacaine provides longer analgesia than conventional local anesthetics when used in regional anesthesia. The analyses of multiple studies on liposomal bupivacaine for TAP blocks and brachial plexus blocks have yielded conflicting results. As a result, no definitive conclusions can be drawn about its efficacy compared to plain bupivacaine.

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Section: Anesthesia and Analgesiamentioning

confidence: 99%

Comparison of Liposomal Bupivacaine and Conventional Local Anesthetic Agents in Regional Anesthesia: A Systematic Review

Jin

Ding

Islam

et al. 2021

Anesthesia &Amp; Analgesia

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“…IV administration of ketorolac (30 or 60 mg), has decreased the postoperative pain severity and subsequent need for opioid analgesics in the recovery period. 24,25 It is beyond doubt that IV lignocaine infusion is an appealing option for perioperative pain management as suggested by our and other studies. Lignocaine infusion is easy to administer and is inexpensive.…”

Section: Discussionmentioning

confidence: 72%

Comparison Between Lignocaine Intravenous Lignocaine Infusion and Ketorolac in Reducing Postoperative Opioid Requirement in Upper Limb Surgeries

Khan

Bajwa²,

Hussain³

et al. 2022

PAFMJ

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Objective: To compare the frequency of opioid requirement, after intravenous lignocaine infusion and ketorolac tromethamine in the upper limb surgeries. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, from Oct 2017 to Apr 2018. Methodology: ASA I/II patients of either gender undergoing upper limb surgery were included. Patients were randomly divided into two equal groups, “L” (Lignocaine) and “K” (Ketorolac). In L-group, patients were given intravenous 1.5 mg/kg lignocaine bolus, followed by 2.0 mg/kg/hr infusion during entire procedure; while in K-group, patients were given intravenous 0.5 mg/kg (maximum 30 mg) ketorolac, at induction. The patients were monitored for 12 hours postoperatively and in case of severe postoperative pain (Visual Analogue Scale score >5), rescue analgesia (intravenous Nalbuphine 0.1 mg/kg) was provided. Results: Total eighty patients were included in the study. There was no statistical difference between the two groups with age (p-value 0.823), gender (p-value 0.808) and ASA status (p-value 0.184). There was statistically significant difference between the two groups in terms of opioid requirement at 1-hour (p-value 0.035), 6-hours (p-value 0.032) and 12-hours (p-value 0.035), with K-group showing more requirement as compared to the L-group. Conclusion: Intraoperative administration of intravenous lignocaine infusion is superior to ketorolac in effective postoperative pain management in patients undergoing upper limb surgeries.

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“…Various techniques, such as intravenous analgesics, thoracic epidural analgesia, thoracic paravertebral block, intercostal blockade, and PECS blocks, may be used for postoperative pain treatment following breast augmentation surgery. 6 , 7 , 8 , 9 , 14 PECS block type-1 is commonly used under US guidance because it is a superfascial block, easy to administer, and has relatively low complication rates. The mechanism of action of PECS block type-1 is related to the neural anatomy of the chest wall, which contains three groups of nerves.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have addressed postoperative analgesia management following breast augmentation. 6 , 7 , 8 , 9 A number of studies have also investigated the efficacy of PECS block for postoperative pain treatment following different types of breast surgery, such as carcinoma, reconstructive, and cosmetic surgeries. 10 , 11 , 12 , 13 , 14 However, to the best of our knowledge, there is no study that evaluates the timing (preoperatively or postoperatively) of the PECS block in the literature.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided pectoral nerve block for pain control after breast augmentation: a randomized clinical study

Çiftçi

Ekinci

Çelik

et al. 2021

Brazilian Journal of Anesthesiology (English Edition)

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A Comparison of 4 Analgesic Regimens for Acute Postoperative Pain Control in Breast Augmentation Patients

Cited by 21 publications

References 50 publications

Comparison of Liposomal Bupivacaine and Conventional Local Anesthetic Agents in Regional Anesthesia: A Systematic Review

Comparison of Liposomal Bupivacaine and Conventional Local Anesthetic Agents in Regional Anesthesia: A Systematic Review

Comparison Between Lignocaine Intravenous Lignocaine Infusion and Ketorolac in Reducing Postoperative Opioid Requirement in Upper Limb Surgeries

Ultrasound-guided pectoral nerve block for pain control after breast augmentation: a randomized clinical study

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